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Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. [1] Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children. [1] Failure to progress can take place during two different phases; the latent phase and active phase of labor. [1]
The first stage of labour is divided into latent and active phases, where the latent phase is sometimes included in the definition of labour, [49] and sometimes not. [50] The latent phase is generally defined as beginning at the point at which the woman perceives regular uterine contractions. [51]
Labor is divided into three stages. First stage of labor starts with the onset of contractions and finishes when the cervix is fully dilated at 10 cm. [15] This stage can further be divided into latent and active labor. The latent phase is defined by cervical dilation of 0 to 6 cm. The active phase is defined by cervical dilation of 6 cm to 10 cm.
Latent phase: 0–3 centimeters; Active labor: 4–7 centimeters; Transition: 8–10 centimeters; Complete: 10 centimeters. Delivery of the infant takes place shortly after this stage is reached (although the mother does not always push right away.)
As the fetal hypothalamus matures, the activation of the hypothalamic–pituitary–adrenal (HPA) axis initiates labor through two hormonal mechanisms. The end pathway of both mechanisms lead to contractions in the myometrium, a mechanical cause of placental separation, which is due to the sheer force and contractile and involutive changes that occur within the uterus, distorting the placentome.
Obstructed labour is said to result in prolonged labour, when the active phase of labour is longer than 12 hours. [ 2 ] The main causes of obstructed labour include a large or abnormally positioned baby, a small pelvis , and problems with the birth canal. [ 2 ]
Labor is separated into 4 stages. The first stage involves latent phase and active phase separated by the dilation of the cervix for 6 to 10 cm. The second stage is the pushing stage. The third stage involves the delivery of the placenta. And the last stage is the contraction of the uterus. [21]
Montevideo units are a method of measuring uterine performance during labor. They were created in 1949 by two physicians, Roberto Caldeyro-Barcia and Hermogenes Alvarez, from Montevideo, Uruguay. They are exactly equal to 1 mmHg within 10 minutes.